At a median follow-up of 44 months, the size of SN metastases was a significant predictor of DFS (p=0.0001) but not OS (p=0.0520).

There was no significant difference in DFS between SN negative patients and SN IHC positive patients (p=0.3775) nor was there a significant difference in OS between these two groups (p=0.6593).

Authors' Conclusions

IHC metastases do not appear to adversely affect prognosis at this time. These results suggest that IHC should not be routinely performed on the SN, nor should treatment decisions be made until results of long-term multicenter trials such as the ACSOG Z0010 study are reported.

Clinical/Scientific Implications:

IHC of SLN definietly leads to upstage of pt which affects treatment decisions.

From early study, IHC + SLN correlates with 7% + axillary LN.

In this cohort pts, IHC + SLN has no impact on the DFS or OS as compared to the pts with IHC- SLN.

At this time, IHC of SNL does not have a role in the treatment decision process.